Account sequences in emergency care discourse

Comparing conversations with simulated patients and manikins in training sessions


  • Keiko Tsuchiya Yokohama City University
  • Frank Coffey Nottingham University Hospitals NHS Trust
  • Stephen Timmons University of Nottingham
  • Sarah Atkins University of Nottingham
  • Bryn Baxendale Nottingham University Hospitals NHS Trust
  • Svenja Adolphs University of Nottingham



account, explanation, corpus-driven discourse analysis, emergency care discourse, healthcare communication, medical simulation training


Effective communication between healthcare professionals (HCPs) and patients is a key factor in medicine. This is particularly the case in emergency care. This article looks at how HCPs provide accounts of medical procedures to patients in emergency care scenarios, using video data of four training sessions, two conducted with simulated patients and two with a manikin. A comparison between these two types of simulation shows how HCPs give accounts in both modalities, which will eventually inform what modality to use for training HCPs with different learning aims. The practices of HCPs' giving accounts to a patient in emergency care training in the UK were analysed, using a corpus-driven discourse analysis. From the analysis, separate account sequences are identified: (1) HCPs' proposal of medical procedures to a patient; (2) HCPs' accounting of the procedure to a patient; and (3) acceptance or rejection by a patient. HCPs' accounting practices were observed in both cases but used less in the scenario with a manikin.

Author Biographies

  • Keiko Tsuchiya, Yokohama City University

    Keiko Tsuchiya (PhD, Nottingham) is Associate Professor of Faculty of Liberal Arts and International Studies at Yokohama City University, Japan, where she teaches English philology and Linguistics and supervises undergraduate and graduate students in Applied Linguistics. Her research interests include multimodal corpus analysis and academic and professional communication, especially in health care and business contexts. She is the author of Listenership Behaviours in Intercultural Encounters: A Time-aligned Multimodal Corpus Analysis (John Benjamins, 2013). Address for correspondence: Faculty of Liberal Arts and International Studies, Yokohama City University, 22-2 Seto, Kanazawa, Yokohama, Kanagawa, 236 0027, Japan. Email: [email protected]

  • Frank Coffey, Nottingham University Hospitals NHS Trust

    Frank Coffey is Head of Service at the Emergency Department, Nottingham University Hospitals' NHS Trust and Director of DREEAM (Department of Research and Education in Emergency medicine, Acute medicine and Major Trauma). He is an Associate Professor at the University of Nottingham and Visiting Professor to the Royal College of Surgeons in Ireland. Frank has a special interest in Interprofessional and Simulation Based Education. Address for correspondence: Emergency Department, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. Email: [email protected]

  • Stephen Timmons, University of Nottingham

    Stephen Timmons is Professor of Health Services Management in the Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, UK. He worked as an NHS manager before doing a PhD in sociology. His main research interests are in the implementation of innovations in health care, sociology of technology, and sociology of the professions. Address for correspondence: Centre for Health Innovation, Leadership and Learning, University of Nottingham, Nottingham University Business School, Jubilee Campus, Nottingham, NG8 1BB, UK. Email: [email protected]

  • Sarah Atkins, University of Nottingham

    Sarah Atkins is Assistant Professor of School of English, University of Nottingham. Her research investigates language and professional communication, primarily in healthcare settings. She has conducted research on the linguistic features of simulation with a range of professional groups, including general practitioners (GPs) and emergency care providers. Her work has a strong emphasis on applying findings into practice. Address for correspondence: School of English, University of Nottingham, Trent Building, University Park, Nottingham, NG7 2RD, UK. Email: [email protected]

  • Bryn Baxendale, Nottingham University Hospitals NHS Trust

    Bryn Baxendale is Consultant Anaesthetist and Director of Trent Simulation & Clinical Skills Centre, Nottingham University Hospitals NHS Trust. He has research interests related to medical and interprofessional healthcare education at undergraduate and postgraduate levels, team and leadership development in clinical practice and healthcare management, and improving patient safety and systems safety at individual, team, and organisational levels. Address for correspondence: The Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham University Hospitals, NG7 2UH, UK. Email: [email protected]

  • Svenja Adolphs, University of Nottingham

    Svenja Adolphs is Professor of English Language and Linguistics at the University of Nottingham, UK. She has published widely on corpus linguistics, language and gesture, multimodality, pragmatics and discourse analysis, as well as on interdisciplinary approaches to the understanding of language use in dynamic contexts. Key publications include 'Spoken corpus linguistics: from monomodal to multimodal' (with Ronald Carter, Routledge 2013), and 'Corpus and context: investigating pragmatic functions in spoken discourse' (John Benjamins Publishing Company 2008). Address for correspondence: School of English, University of Nottingham, Trent Building, University Park, Nottingham, NG7 2RD, UK. Email: [email protected]


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How to Cite

Tsuchiya, K., Coffey, F., Timmons, S., Atkins, S., Baxendale, B., & Adolphs, S. (2019). Account sequences in emergency care discourse: Comparing conversations with simulated patients and manikins in training sessions. Journal of Applied Linguistics and Professional Practice, 12(1), 72-93.